Chinese Medical Sciences Journal最新文献

{"title":"SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report","authors":"Li-Hua Guo,&nbsp;Min Miao,&nbsp;Guo-Liang Ye","doi":"10.24920/004273","DOIUrl":"10.24920/004273","url":null,"abstract":"<div><div>Hepatocelluar carcinoma presenting as a biliary duct tumor thrombus is a relatively rare entity, with poor prognosis. The primary clinical manifestation of this disease is obstructive jaundice, which can often be misdiagnosed. A 59-year-old female patient was admitted with sudden onset of abdominal pain. Laboratory tests suggested obstructive jaundice, and enhanced magnetic resonance imaging of the upper abdomen did not show obvious biliary dilatation. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography suggested an occupying lesion in the upper bile duct. SpyGlass and biopsy finally confirmed hepatocellular carcinoma with right hepatic duct tumor thrombus hemorrhage. The SpyGlass Direct Visualization System, as an advanced biliary cholangioscopy device, showed the advantages of single-person operation as well as easy access to and visualization of the lesion.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 309-314"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iridociliary Body Metastasis of Atypical Carcinoid: Case Management with Intravitreal Anti-Vascular Endothelial Growth Factor Injections","authors":"Yang Zhang,&nbsp;Ai-Ling Bian,&nbsp;Rong-Ping Dai","doi":"10.24920/004268","DOIUrl":"10.24920/004268","url":null,"abstract":"<div><div>We report a rare case mvolving a 52-year-old female diagnosed with an atypical bronchial carcinoid tumor with metastases to the mediastinum, hilar lymph nodes, breast, and pancreas. In additional, the patient had metastases to the iris and ciliary body, resulting in progressive vision loss in her left eye. Treatment was successful by intravitreal injections of anti-vascular endothelial growth factor.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 305-308"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Gut Microbiota and its Metabolites on Progression of Metabolic Associated Fatty Liver Disease","authors":"Yuan-Yuan Wang ,&nbsp;Hai-Lian Lin ,&nbsp;Ke-Lang Wang ,&nbsp;Gen-Xiang Que ,&nbsp;Ting Cao ,&nbsp;La-Mei Zhu ,&nbsp;Xia Yang ,&nbsp;Xue-Feng Yang","doi":"10.24920/004220","DOIUrl":"10.24920/004220","url":null,"abstract":"<div><div>Metabolic associated fatty liver disease (MAFLD) has become a prevalent chronic liver disease worldwide because of lifestyle and dietary changes. Gut microbiota and its metabolites have been shown to play a critical role in the pathogenesis of MAFLD. Understanding of the function of gut microbiota and its metabolites in MAFLD may help to elucidate pathological mechanisms, identify diagnostic markers, and develop drugs or probiotics for the treatment of MAFLD. Here we review the pathogenesis of MAFLD by gut microbiota and its metabolites and discuss the feasibility of treating MAFLD from the perspective of gut microbes.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 286-296"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Blood Pressure Lability Acts as a Key Mediator in the Impacts of Goal-Directed Fluid Therapy on Postoperative Complications in Patients Undergoing Major Spine Surgery","authors":"Lu Che,&nbsp;Jia-Wen Yu,&nbsp;Yue-Lun Zhang,&nbsp;Li Xu,&nbsp;Yu-Guang Huang","doi":"10.24920/004202","DOIUrl":"10.24920/004202","url":null,"abstract":"<div><h3>Objective</h3><div>Although goal-directed fluid therapy (GDFT) has been proven to be effective in reducing the incidence of postoperative complications, the underlying mechanisms remain unknown. The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications. We further tested the role of this mediation effect using mean arterial pressure, a hemodynamic indicator.</div></div><div><h3>Methods</h3><div>This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis. We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications. We conducted mediation analysis using the mediation package in R (version 3.1.2), based on 5,000 bootstrapped samples, adjusting for covariates.</div></div><div><h3>Results</h3><div>Among the 300 patients in the study, 40% (120/300) developed postoperative complications within 30 days. GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders (odds ratio: 0.460, 95% <em>CI:</em> 0.278, 0.761; <em>P</em> = 0.003). The total effect of GDFT on postoperative complications was –0.18 (95% <em>CI</em>: –0.28, –0.07; <em>P</em> &lt; 0.01). The average causal mediation effect was –0.08 (95% <em>CI</em>: –0.15, –0.04; <em>P</em> &lt; 0.01). The average direct effect was –0.09 (95% <em>CI</em>: –0.20, 0.03; <em>P</em> = 0.17). The proportion mediated was 49.9% (95% <em>CI</em>: 18.3%, 140.0%).</div></div><div><h3>Conclusions</h3><div>The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications. Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 257-264"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10153046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation Between Amyotrophic Lateral Sclerosis and Mimics Using Quantitative Analysis of Fsciculation with Muscle Ultrasound","authors":"Jing Fan ,&nbsp;Yi Li ,&nbsp;Jing-Wen Niu ,&nbsp;Nan Hu ,&nbsp;Yu-Zhou Guan ,&nbsp;Li-Ying Cui ,&nbsp;Ming-Sheng Liu","doi":"10.24920/004282","DOIUrl":"10.24920/004282","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the diagnostic accuracy of the intensity of fasciculation evaluated by muscle ultrasound in the differential diagnosis of amyotrophic lateral sclerosis (ALS).</div></div><div><h3>Methods</h3><div>We prospectively recruited patients who had ALS and neuropathy-radiculopathy attending Peking Union Medical College Hospital from 2017 to 2020. Healthy adults from a community were recruited as healthy controls. Muscle strength was assessed using the Medical Research Council (MRC) scale. At the first visit to the hospital, patients were assessed for maximal grade of fasciculations, total fasciculation score, and fasciculation grade in 16 muscle groups of bilateral upper and lower limbs using ultrasonography. The sensitivity and specificity of maximal grade of fasciculations, total fasciculation score, and fasciculation grade for the diagnosis of ALS were assessed by receiver operating characteristic analyses.</div></div><div><h3>Results</h3><div>The percentage of limb muscles with a maximal fasciculation grade higher than grade 2 in ALS patients and neuropathy-radiculopathy patients was 84.9% and 9.8%, respectively (<em>χ</em>² = 172.436, <em>P &lt;</em> 0.01). Of the 16 limb muscles detected, the total fasciculation score [median (interquartile range)] was 29 (15, 41) in ALS patients and 3 (0, 8) in neuropathy-radiculopathy patients (<em>Z</em> = 9.642, <em>P</em> &lt; 0.001). Remarkable fasciculations were seen in ALS patients whose muscles with a MRC score ranging from 2 to 4, followed by patients with MRC score 5, and then in those with MRC score 0 and 1. The sensitivity and specificity of total fasciculation score for diagnosis of ALS were 80.6% and 93.4%, respectively (cut-off value 14). In patients with ALS, for muscles with MRC score 4 and 5, the percentage of muscles with fasciculation grades ≥ 3 was 42.3% and 24.1% respectively, while in neuropathy-radiculopathy patients, the percentage for muscles with MRC score 4 and 5 was only 1.7% and 0, respectively.</div></div><div><h3>Conclusion</h3><div>A combined analysis of fasciculation intensity and MRC score of the limb muscles may be helpful for differential diagnosis of ALS.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 265-272"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the Clinical Application of Trendelenburg Position","authors":"Qing Qiu ,&nbsp;Xu Shen","doi":"10.24920/004231","DOIUrl":"10.24920/004231","url":null,"abstract":"<div><div>The Trendelenburg position and reverse Trendelenburg position are frequently employed during lower abdominal surgery to achieve optimal surgical field visualization and complete exposure of the operative site, particularly under pneumoperitoneum conditions. However, these positions can have significant impacts on the patient's physiological functions. This article overviews the historical background of Trendelenburg position and reverse Trendelenbury position, their effects on various physiological functions, recent advancements in their clinical applications, and strategies for preventing and managing associated complications.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 297-304"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulations for the Manufacture and Control of Live Poliovirus Vaccine: International Experience and China's Path","authors":"Miao Wu","doi":"10.24920/004284","DOIUrl":"10.24920/004284","url":null,"abstract":"<div><div>The eradication of poliomyelitis is a landmark achievement in the history of public health, providing strong protection for children's health. The introduction of the Chinese Regulations for the Manufacture and Control of Live Poliovirus Vaccine is a prerequisite and safeguard for the large-scale production and use of domestically produced live poliovirus vaccines, serving as an indispensable component of vaccine safety. This article, based on archival documents, letters, collections of essays, and oral interviews, examines the historical experience of the development of Chinese Regulations for the Manufacture and Control of Live Poliovirus Vaccine. It contends that the emphasis on localization and the active engagement in international cooperation are critical factors in the swift introduction of Chinese Regulations for the Manufacture and Control of Live Poliovirus Vaccine.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 4","pages":"Pages 315-320"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Prediction Value and Biological Functions of Non-Apoptotic Regulated Cell Death Genes in Lung Adenocarcinoma","authors":"Hao-Ling Li ,&nbsp;Jun-Xian Wang ,&nbsp;Heng-Wen Dai ,&nbsp;Jun-Jie Liu ,&nbsp;Zi-Yang Liu ,&nbsp;Ming-Yuan Zou ,&nbsp;Lei Zhang ,&nbsp;Wen-Rui Wang","doi":"10.24920/004222","DOIUrl":"10.24920/004222","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the potential biological functions and prognostic prediction values of non-apoptotic regulated cell death genes (NARCDs) in lung adenocarcinoma.</p></div><div><h3>Methods</h3><p>Transcriptome data of lung adenocarcinoma were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. We identified differentially expressed NARCDs between lung adenocarcinoma tissues and normal tissues with R software. NARCDs signature was constructed with univariate Cox regression analysis and the least absolute shrinkage and selection operator Cox regression. The prognostic predictive capacity of NARCDs signature was assessed by Kaplan-Meier survival curve, receiver operating characteristic curve, and univariate and multivariate Cox regression analyses. Functional enrichment of NARCDs signature was analyzed with gene set variation analysis, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes. In addition, differences in tumor mutational burden, tumor microenvironment, tumor immune dysfunction and exclusion score, and chemotherapeutic drug sensitivity were analyzed between the high and low NARCDs score groups. Finally, a protein-protein interaction network of NARCDs and immune-related genes was constructed by STRING and Cytoscape software.</p></div><div><h3>Results</h3><p>We identified 34 differentially expressed NARCDs associated with the prognosis, of which 16 genes (<em>ATIC, AURKA, CA9, ITGB4, DDIT4, CDK5R1, CAV1, RRM2, GAPDH, SRXN1, NLRC4, GLS2, ADRB2, CX3CL1, GDF15,</em> and <em>ADRA1A</em>) were selected to construct a NARCDs signature. NARCDs signature was identified as an independent prognostic factor (<em>P</em> &lt; 0.001). Functional analysis showed that there were significant differences in mismatch repair, pS3 signaling pathway, and cell cycle between the high NARCDs score group and low NARCDs score group (all <em>P</em> &lt; 0.05). The NARCDs low score group had lower tumor mutational burden, higher immune score, higher tumor immune dysfunction and exclusion score, and lower drug sensitivity (all <em>P &lt;</em> 0.05). In addition, the 10 hub genes (<em>CXCL5, TLR4JUN, IL6, CCL2, CXCL2, ILA, IFNG, IL33,</em> and <em>GAPDH</em>) in protein-protein interaction network of NARCDs and immune-related genes were all immune-related genes.</p></div><div><h3>Conclusion</h3><p>The NARCDs prognostic signature based on the above 16 genes is an independent prognostic factor, which can effectively predict the clinical prognosis of patients of lung adenocarcinoma and provide help for clinical treatment.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 3","pages":"Pages 178-190"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10069362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuproptosis-Related 4-Gene Risk Model for Predicting Immunotherapy Drug Response and Prognosis of Kidney Renal Clear Cell Carcinoma","authors":"Jin-Shuai Guo ,&nbsp;Hao Ding ,&nbsp;Peng-Yu Wu ,&nbsp;Zi-Yi Xin ,&nbsp;Jian-Xin Li ,&nbsp;Hyon-Su Jo ,&nbsp;Zhen-Hai Ma","doi":"10.24920/004223","DOIUrl":"10.24920/004223","url":null,"abstract":"<div><h3>Background</h3><p>Kidney renal clear cell carcinoma (KIRC) is one of the most common renal malignancies with a high mortality rate. Cuproptosis, a novel form of cell death, is strongly linked to mitochondrial metabolism and is mediated by protein lipoylation, leading to a proteotoxic stress response and cell death. To date, few studies have ellucidated the holistic role of cuproptosis-related genes (CRGs) in the pathogenesis of KIRC.</p></div><div><h3>Methods</h3><p>We comprehensively and completely analyzed the RNA sequencing data and corresponding clinical information from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. We screened for differentially expressed CRGs and constructed a prognostic risk model using univariate and multivariate Cox proportional regression analyses. Kaplan-Meier analysis was performed and receiver operating characteristic (ROC) curves were plotted to predict the prognosis of KIRC patients. Functional enrichment analysis was utilized to explore the internal mechanisms. Immune-related functions were analyzed using single-sample gene set enrichment analysis (ssGSEA), tumour immune dysfunction and exclusion (TIDE) scores, and drug sensitivity analysis.</p></div><div><h3>Results</h3><p>We established a concise prognostic risk model consisting of four CRGs (DBT, DLAT, LIAS and PDHB) to predict the overall survival (OS) in KIRC patients. The results of the survival analysis indicated a significantly lower OS in the high-risk group as compared to the patients in the low-risk group. The area under the time-dependent ROC curve (AUC) at 1, 3, and 5 year was 0.691, 0.618, and 0.614 in KIRC. Functional enrichment analysis demonstrated that CRGs were significantly enriched in tricarboxylic acid (TCA) cycle-related processes and metabolism-related pathways. Sorafenib, doxorubicin, embelin, and vinorelbine were more sensitive in the high-risk group.</p></div><div><h3>Conclusions</h3><p>We constructed a concise CRGs risk model to evaluate the prognosis of KIRC patients and this may be a new direction for the diagnosis and treatment of KIRC.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 3","pages":"Pages 191-205"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Oxalate Consumption and Some Individual Habits with the Risk of Kidney Stones","authors":"Nahid Zainodini ,&nbsp;Periklis Dousdampanis ,&nbsp;Zahra Ahmadi ,&nbsp;Maryam Mohamadi ,&nbsp;Alireza Nazari","doi":"10.24920/004207","DOIUrl":"10.24920/004207","url":null,"abstract":"<div><p>Kidney stone is a highly recurrent disease in the urinary tract system. Most kidney stones are calcium stones, usually consisting of either calcium oxalate or calcium phosphate. Supersaturation of soluble calcium, oxalate, phosphate, and citrate in the urine is the basis for calcium stone formation. Genetics, diet, low physical activity, and individual habits contribute to the formation of kidney stones. In this review, the associations of the risk of kidney stones with oxalate consumption and some individual habits, such as smoking, alcohol drinking, and opium consumption, are summarized.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"38 3","pages":"Pages 250-256"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10467764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}